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`DEPARTMENT OF HEALTH AND HUMAN SERVICES
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`NDA 202155/S-018
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`Food and Drug Administration
`Silver Spring MD 20993
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`SUPPLEMENT APPROVAL
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`Bristol-Myers Squibb Company
`Attention: Diptee Gajjar, B.Pharm, PhD
`Global Regulatory Lead, Global Regulatory & Safety Sciences
`PO Box 5326
`Princeton NJ, 08543
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`Dear Dr. Gajjar:
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`Please refer to your Supplemental New Drug Application (sNDA) dated August 11, 2017,
`received August 11, 2017, submitted under section 505(b) of the Federal Food, Drug, and
`Cosmetic Act (FDCA) for Eliquis (apixaban) 2.5 and 5 mg tablets.
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`This Prior Approval supplemental new drug application provides for revisions to labeling
`regarding drug interactions with clarithromycin.
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`APPROVAL & LABELING
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`We have completed our review of this supplemental application, as amended. It is approved,
`effective on the date of this letter, for use as recommended in the enclosed, agreed-upon labeling
`text.
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`CONTENT OF LABELING
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`As soon as possible, but no later than 14 days from the date of this letter, submit the content of
`labeling [21 CFR 314.50(l)] in structured product labeling (SPL) format using the FDA
`automated drug registration and listing system (eLIST), as described
`at http://www.fda.gov/ForIndustry/DataStandards/StructuredProductLabeling/default.htm.
`Content of labeling must be identical to the enclosed labeling (text for the package insert), with
`the addition of any labeling changes in pending “Changes Being Effected” (CBE) supplements,
`as well as annual reportable changes not included in the enclosed labeling.
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`Information on submitting SPL files using eList may be found in the guidance for industry titled
`“SPL Standard for Content of Labeling Technical Qs and As”
`at http://www.fda.gov/downloads/DrugsGuidanceComplianceRegulatoryInformation/Guidances/
`UCM072392.pdf.
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`The SPL will be accessible from publicly available labeling repositories.
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`Reference ID: 4218935
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`NDA 202155/S-018
`Page 2
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`Also within 14 days, amend all pending supplemental applications that include labeling changes
`for this NDA, including CBE supplements for which FDA has not yet issued an action letter,
`with the content of labeling [21 CFR 314.50(l)(1)(i)] in MS Word format, that includes the
`changes approved in this supplemental application, as well as annual reportable changes and
`annotate each change. To facilitate review of your submission, provide a highlighted or marked-
`up copy that shows all changes, as well as a clean Microsoft Word version. The marked-up copy
`should provide appropriate annotations, including supplement number(s) and annual report
`date(s).
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`REPORTING REQUIREMENTS
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`We remind you that you must comply with reporting requirements for an approved NDA
`(21 CFR 314.80 and 314.81).
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`If you have any questions, call Michael Monteleone, Associate Director for Labeling, at (301)
`796-1952.
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`Sincerely,
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`{See appended electronic signature page}
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`Mary Ross Southworth, PharmD
`Deputy Director for Safety
`Division of Cardiovascular and Renal Products
`Office of Drug Evaluation I
`Center for Drug Evaluation and Research
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`ENCLOSURE(S):
`Content of Labeling
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`Reference ID: 4218935
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`---------------------------------------------------------------------------------------------------------
`This is a representation of an electronic record that was signed
`electronically and this page is the manifestation of the electronic
`signature.
`---------------------------------------------------------------------------------------------------------
`/s/
`----------------------------------------------------
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`MARY R SOUTHWORTH
`02/09/2018
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`Reference ID: 4218935
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